Exploring effective factors in the implementation of neonatal pain management from of nurse’s perspectives in neonatal intensive care unit: a content analysis

authors:

avatar nasrin mehrnoush , avatar Tahereh Ashktorab , * , avatar mohammad heidarzadeh , avatar sirous momenzadeh

Koomesh: Vol.19, issue 2; 309-319
published online: June 02, 2017
article type: issue_documents_importer
received: January 02, 2016
accepted: January 02, 2017

how to cite: mehrnoush N, Ashktorab T, heidarzadeh M, momenzadeh S. Exploring effective factors in the implementation of neonatal pain management from of nurse’s perspectives in neonatal intensive care unit: a content analysis. koomesh. 2017;19(2):e151083. 

Abstract

Introduction: Despite growing knowledge about pain assessment and intervention, neonatal infant pain remains a challenge to neonatal care providers because these infants cannot speak and advocate for themselves. The aim of this study was to explore the effective factors in the implementation of neonatal pain management from of nurse’s perspectives in NICU. Materials and Methods: In this qualitative study, a content analysis approach was used. Participants consisted of 25 nurses working in neonatal intensive care unit of Alavi hospital in Ardabil, North east of Iran. Data were collected using four focus group discussions and were analyzed using conventional content analysis. Results: The results of the data analysis eventually led to the creation of two abstract themes that were effective for pain management. The two themes “Individual Factors” and “Organizational Factors” were introduced. First theme contains categories of “Knowledge of the personnel” and “Attitude of the personnel” and the second theme include “Policy of pain control”, “Working conditions of nurse ” and “Management performance” Conclusion: The findings of this research indicate that the implementation of neonatal pain management has been affected by the problems and obstacles that are not a priority in the field of study about pain management Therefore there is a need for strategies to reduce or remove these barriers

References

  • 1.

    Urso AM. The reality of neonatal pain and the resulting effects. J Neonatal Nurs 2007; 13: 236-238.

  • 2.

    IM H, Kim E, Park E, Sung K, Oh W. Pain reduction of heel stick in neonates: yakson massage compared to non- nutritive sucking. J Trop Pediatr 2007; 54: 31-35.

  • 3.

    Irani H, Esna-Ashari M, Marozi P, Naseri F. Effect of oral glucose on newborn pain intensity in vaccination. J Gonabad Univ Med Sci 2005; 11: 5-9 (Persian).

  • 4.

    Roshan PA, Pasha YZ, Ahmadpur M, Ahmadi MH, Mohammadzadeh I, Arzani A. Comparison of sucrose, breast and EMLA cream on acute pain caused by blood sampling in term neonates. J Babol Univ Med Sci 2013; 15: 16-23 (Persian).

  • 5.

    Reihani T, Mohebi T, Boskabadi H, Ghulami H, Abadi AGQ. The impact of fetal position during venous blood sampling on pain and physiological indicator in premature infants. J Evidence-Based Care 2012; 2: 47-55. (Persian).

  • 6.

    Ballweg D. Neonatal and pediatric pain management: standards and application. Pediatr Child Health 2008; 18: S61-S66.

  • 7.

    Cong X, McGrath J, Delancy C, Chen H, Liang S, Vazquez V, et al. Neonatal nurses perceptions of pain management: survey of United States and China. Pain Manag Nurs 2013; 1-11.

  • 8.

    Boxwell G. Neonatal intensive care nursing.2th Edition, London: Rout Ledge Company 2010.

  • 9.

    Cignacco E, Hamers JP, Stoffel L, Lingen RA, Gessler P, McDougall J, Nelle M. The efficacy of nonpharmacological interventions in the management of procedural pain in preterm and term neonates. Eur J Pain 2007; 11: 139-152.

  • 10.

    Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA 2008; 300: 60-70.

  • 11.

    Byrd PJ, Gonzales I, Parsons V. Exploring barriers to pain management in newborn intensive care units: a pilot survey of NICU nurses. Adv Neonatal Care 2009; 9: 299-306.

  • 12.

    Young J, Barton M, Richards-Dawson M, Trotman H. Knowledge, perception and practices of healthcare professionals at tertiary level hospitals in Kingston, Jamaica, regarding neonatal pain management. West Indian Med J 2008; 57: 28-32.

  • 13.

    Schultz M, LoughranFowlds A, Spence K. Neonatal pain: a comparison of the beliefs and practices of junior doctors and current best evidence. J Paediatr Child Health 2010; 46: 23-28.

  • 14.

    Plkki T, Korhonen A, Laukkala H, Saarela T, VehvilinenJulkunen K, Pietil AM. Nurses attitudes and perceptions of pain assessment in neonatal intensive care. Scand J Caring Sci 2010; 24: 49-55.

  • 15.

    Latimer MA, Johnston CC, Ritchie JA, Clarke SP, Gilin D. Factors affecting delivery of EvidenceBased procedural pain care in hospitalized neonates. J Obstet Gynecol Neonatal Nurs 2009; 38: 182-194.

  • 16.

    Cong X, Delaney C, Vazquez V. Neonatal nurses' perceptions of pain assessment and management in NICUs: a national survey. Adv Neonatal Care 2013; 13: 353-360.

  • 17.

    Ranjbar H, DehghanNayeri N, Soleimani MA, Chan YH, Haghdoost A. What is the most effective method of pain reduction during intravenous cannulation in children? A systematic review and meta-analysis study. Koomesh 2016; 17: 533-546 (Persian).

  • 18.

    Lake SW. Barriers to effective pain management in preterm and critically Ill neonates 2013. Theses and Dissertations Nursing. Paper 7.

  • 19.

    Asgari MR, Mohammadi E, Khoshknab M, Tamadon MR. Hemodialysis patients' perception from nurses' role in their adjustment with hemodialysis: A qualitative study. Koomesh 2011; 12: 385-396 (Persian).

  • 20.

    Graneheim U, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24: 105-112.

  • 21.

    Polit D, Beck C. Nursing research: Generating and assessing evidence for nursing practice. Philadelphia: Lippincott Williams & Wilkins; 2012.

  • 22.

    De Aymar CL, Lima LSd, Dos Santos CM, Moreno EA, Coutinho SB. Pain assessment and management in the NICU: analysis of an educational intervention for health professionals. J Pediatr (Rio J) 2014; 90: 308-315.

  • 23.

    Andersen R, GreveIsdahl M, Jylli L. The opinions of clinical staff regarding neonatal procedural pain in two Norwegian neonatal intensive care units. Acta Paediatrica 2007; 96: 1000-1003.

  • 24.

    Akuma AO, Jordan S. Pain management in neonates: a survey of nurses and doctors. J Adv Nurs 2012; 68: 1288-1301.

  • 25.

    Ozawa M, Yokoo K. Pain management of neonatal intensive care units in Japan. Acta Paediatr 2013; 102: 366-372.

  • 26.

    Mohebbi P, Azimzadeh R. Barrier of implementing non-pharmacological pain management in children and presented intereventions by nurses. Holistic Nurs Midwifery 2013; 24: 40-48 (Persian).

  • 27.

    Polki T, Laukkala H, Vehvilainen-Julkunen K, Pietila A. Factor influencing nurses' use of non-pharmacological pain alleviation methods in pediatric patients. Scand J Caring Sci 2003; 17: 373.##.